Contract Pharmacy Details

BIOPLUS SPECIALTY PHARMACY CA
DSH050599 UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER

Covered Entity Details

Entity Name

UNIVERSITY OF CALIFORNIA DAVIS MEDICAL CENTER

Subdivision Name

Type

Disproportionate Share Hospital

340B ID

DSH050599

Entity Address

2315 STOCKTON BLVD
SACRAMENTO, CA 95817

Medicare Provider Number

050599

Participating Start Date

1/1/1999

Last Recertification Date

8/22/2024

Pharmacy Details

Pharmacy Name

BIOPLUS SPECIALTY PHARMACY CA

Pharmacy Address

7373 LINCOLN WAY
GARDEN GROVE, CA 92841

Pharmacy Comments

09/10/2014

Contract Details

Approval Date

1/8/2015

Contract Begin Date

4/1/2015

Carve-In Effective Date

Contract Comments

Contract Termination Date
Termination Reason

2/15/2017
Ownership change

Contacts

Covered Entity Signing Official

TIMOTHY MAURICE, CHIEF FINANCIAL OFFICER
(916) 734-4055

Contract Pharmacy Representative

Modern Health
Brenda Goodman, Senior Vice President, HIV/TP
(323) 868-7550

Signed By Date

1/8/2015

340B Drug Pricing Program Database